Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $47.92 / $55.95 / $91.28	Facility	26	$47.92	$55.95	$91.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.95 / $160.36 / $272.42	Professional		$78.95	$160.36	$272.42
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $45.45 / $49.43 / $88.00	Professional	26	$45.45	$49.43	$88.00
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $99.40 / $117.06 / $208.96	Professional	TC	$99.40	$117.06	$208.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $118.01 / $121.32 / $141.55	Professional		$118.01	$121.32	$141.55
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.97 / $35.43 / $65.56	Professional	26	$34.97	$35.43	$65.56
Ambetter Facility/Professional Professional Modifier TC Low / Median / High Price $80.73 / $132.35 / $132.35	Professional	TC	$80.73	$132.35	$132.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $175.51 / $238.42 / $369.55	Professional		$175.51	$238.42	$369.55
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $54.25 / $70.20 / $99.68	Professional	26	$54.25	$70.20	$99.68
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $263.26 / $357.63 / $554.32	Professional	50	$263.26	$357.63	$554.32
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $121.25 / $168.22 / $260.74	Professional	TC	$121.25	$168.22	$260.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.90 / $119.37 / $191.76	Professional		$45.90	$119.37	$191.76
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $54.02 / $54.02 / $54.02	Facility	26	$54.02	$54.02	$54.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.29 / $276.64 / $484.14	Professional		$159.29	$276.64	$484.14
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $44.84 / $65.51 / $113.29	Professional	26	$44.84	$65.51	$113.29
Cigna Facility/Professional Professional Modifier 50 Low / Median / High Price $231.34 / $231.34 / $264.19	Professional	50	$231.34	$231.34	$264.19
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $112.13 / $211.12 / $369.47	Professional	TC	$112.13	$211.12	$369.47
United Facility/Professional Professional Modifier Low / Median / High Price $158.29 / $229.27 / $366.83	Professional		$158.29	$229.27	$366.83
United Facility/Professional Professional Modifier 26 Low / Median / High Price $44.45 / $54.50 / $99.54	Professional	26	$44.45	$54.50	$99.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $112.77 / $168.29 / $279.56	Professional	TC	$112.77	$168.29	$279.56